How Insurers Inadequately Report Medicaid Fraud

The Senate released its version (a.k.a. Better Care Reconciliation Act BCRA) of the House's AHCA. Payers and providers adjust as needed because healthcare reforms, like BCRA, AHCA, and ACA, continuously move through state and federal legislatures. Today's blog, pulls together summaries from numerous resources allowing you a quick glimpse or a deep dive into what waits around the corner. Here are 10 instances which can help you better identify when its time to look for a partner.

AMA Passes Augmented Intelligence Policy

The American Medical Association passed its first policy addressing augmented intelligence in the healthcare industry during its annual meeting in Chicago, which ran June 7 to June 13. The policy suggests tasks for the AMA to address regarding the use of AI in healthcare, with a focus on encouraging healthcare stakeholders and federal policymakers to prioritize "user-centered design." The initiative builds on a proposed a "baseline policy" the association laid out in a May report to its board of trustees.

How Can Medicaid Coverage Combat Opioids?

CMS has released new resources describing how states can leverage Medicaid services and health IT tools to support beneficiaries battling opioid addiction. The organization released an Informational Bulletin to guide states on how to cover critical treatment services for Medicaid eligible infants with Neonatal Abstinence Syndrome (NAS), a postnatal drug withdrawal syndrome occurring primarily among babies exposed to opioids during gestation or shortly after birth.

CDC: America’s Uninsured Rate Rising During Trump’s First Year

The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.

Trump Administration Plan To Lower Drug Prices and Reduce Costs

The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.

Study: Hospital Prices Show ‘mind-boggling’ Variation

The prices hospitals negotiate with health insurance companies vary enormously within and across geographic regions in the United States, according to a new study coauthored by Zack Cooper (Yale), Stuart Craig (University of Pennsylvania), Martin Gaynor (Carnegie Mellon), and John Van Reenen (London School of Economics).

Health Plan Strategies For Member Retention

Healthcare is a labor-driven service that depends on the talent and skills of every staff member, from the C-suite to nurses. Finding and keeping this talent is paramount to running a cost-effective organization that provides exceptional care was an observation from an article by Mackenzie Bean by Becker Hospital Review. Growing turnover rates significantly impact profitability.

Impact of Short-Term Limited Duration Health Insurance Shortchanged

NCQA’s Health Insurance Plan Ratings 2017–2018 compare the quality and services of more than 1,000 health plans in the United States and provide consumers with a practical and meaningful guide to understanding their health care options and choosing the best health plans for themselves and their families. National Committee for Quality Assurance (NCQA) is releasing its 2017 Health Insurance Plan Ratings. These ratings provide consumers with a more accurate picture of how health insurance plans perform in the key quality areas of consumer satisfaction, prevention and treatment.

2018-04-24T14:14:13+00:00 By |Health Insurance, Uncategorized|

Population Health Management Update: Numerof Survey Report

Now in its third year, Numerof’s State of Population Health Management survey provides an in-depth, national look at the pace of change from fee-for-service. Conducted in collaboration with Dr. David Nash, Dean of the Jefferson College of Population Health, the study synthesizes survey responses from more than 400 executives and interviews with key decision makers across U.S. healthcare delivery

What Insurers Need For ACA Market Plan Decisions

ACA Increases profitability for insurers, despite significant initial financial losses in the individual market after the key provisions of the Affordable Care Act (ACA) took effect. Health insurer profitability in the individual market rose due to substantial premium increases, government premium tax credits that pay for those premium increases, and the large, government-funded, Medicaid expansion. Here are 10 instances which can help you better identify when its time to look for a partner.

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